• Corina Glanzmann, Bernhard Frey, Priska Vonbach, and Christoph R Meier.
• Hospital Pharmacy, University Children's Hospital Zürich, Steinwiesstrasse 75, 8032, Zürich, Switzerland. pharma@kispi.uzh.ch.
• Pediatr. Nephrol. 2016 Jan 1; 31 (1): 145-51.

BackgroundAcute kidney injury (AKI) is a serious condition in critically ill children. Nephrotoxic medication exposure is a common contributing factor to AKI, but little literature is available in pediatrics. The aim of the present study was to assess potential associations between drugs and the risk of developing AKI.MethodsWe performed a retrospective case-control study in a pediatric intensive care unit (PICU). Cases were patients who developed AKI during PICU stay. Patients without AKI served as controls and were matched to cases by age and gender in a one-to-one ratio.ResultsOne hundred case-control pairs were included. Cases were not statistically different from controls with regard to median weight and main diagnoses, but differed with regard to the need for mechanical ventilation, severity of illness, and median length of PICU stay. Multivariate models revealed a statistically significant higher risk of developing AKI for patients treated with metamizole, morphine, paracetamol, and tropisetron. A similar risk could be shown for medication groups, namely glucocorticoids, betalactam antibiotics, opioids, and non-steroidal anti-inflammatory drugs.ConclusionsThe results suggest that drugs are associated with acute renal dysfunction in critically ill children, but the multifactorial causes of AKI should be kept in mind.

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